Psychiatric hospital is ordered to close

23rd July 2012 · 0 Comments

By Zoe SullivanContributing Writer

The state’s healthcare system has been like a prize fighter on a losing streak. On June 13, the state announced cuts of roughly $551 million from its Medicaid budget, the program that ensures access to health care for the state’s lowest- income residents. The Louisiana State University (LSU) hospital system which serves a high percentage of this population received an blow worth $329 million, roughly a quarter of its operating budget, raising the possibility that the statewide system will have to be reorganized.

One casualty of the cuts is the Southeast Louisiana State Hospital (SELH) in Mandeville, one of the state’s three psychiatric hospitals. According to Tom Gasparoli, a spokesperson with the Department of Health and Hospitals (DHH), the hospital will be closing on October 1. When it shuts its doors, it will leave 300 employees out of work and force the transfer of its 176 in-patients to different treatment facilities.

DHH Secretary Bruce Greenstein said in a press release issued by his department on the that while the federal funding formula had changed, “our focus remains on ensuring the people of Louisiana have access to quality health care services in the most effective, efficient and sustainable way possible. We are proud to say there will not be reductions to essential services.”

No representative of DHH or the Governor’s Office was available for an interview with The Louisiana Weekly.

Since SELH is close to New Orleans, some fear that the displacement will add additional strain to the city’s already over-burdened hospital and jail structures. St. Tammany Parish Presi­dent Pat Brister sent an email statement to The Louisiana Weekly expressing her concerns. “There are many organizations that provide mental health assistance in St. Tammany, but there are not enough hospital beds to meet current needs. It will be a daunting task to find available facilities when the number of beds is further reduced.”

New Orleans Health Commis­sioner, Dr. Karen DeSalvo spoke on behalf of the Landrieu administration when she offered a statement to The Louisiana Weekly. “The congressionally mandated cuts will be a potentially devastating blow to the state’s ability to provide critical services,” DeSalvo wrote in an email. “The closure of SELA will dramatically reduce the number of beds available to our city and comes on the heels of closure of NOAH and beds at DePaul.” The Commis­sioner also pointed out that the local future of psychiatric medicine is threatened concerns since SELH serves as a training facility for Tulane School of Medicine’s psychiatrists.

One of Tulane’s psychiatry faculty members, Dr. Mordecai Potash, spoke with The Louisiana Weekly from SELH where he works. He pointed out that Tulane is not the only educational institution that works with the hospital, and mentioned a summer internship that medical students at LSU undertake at SELH after their first year of study and 16 nursing schools that also provide practical training on the hospital’s campus.

Stressing that the hospital has been evaluated as “a pocket of excellence in an otherwise troubled mental health system,” Potash said that there was no logical reason to close the facility. He also stressed that its peaceful, park-like environment offers patients a tranquil place for recovery. This, he said, contrasts with many hospitals where mental health patients are “in the back of some hospital in a locked unit, wherever they are the least noticeable to the rest of the hospital.”

Potash also expressed his view that the closure will have a disproportionate impact on African Americans. “They disproportionately don’t have the kind of mental health coverage that would provide them with private psychiatric/mental health care, and so they tend to be more reliant on state services.”

The cuts come as Congress adjusts the Federal Medical Assistance Percentage (FMAP) formula for Louisiana, which saw a boost in the aftermath of Hurricane Katrina. The formula is based on individual incomes, and Senator Landrieu successfully argued that the state should not penalized because some residents had received large sums from insurance companies to settle damage claims.

Bringing a law enforcement perspective to the closing, Dr. Daniel Gore, the Medical Director of the Orleans Parish Sheriff’s Office told The Louisiana Weekly that “anytime you close an in-patient facility, there are going to be fewer patients requiring in-patient hospitalization who have access to that care, and those people will likely end up on the streets.” Gore added that the jail would likely see a “trickle-down increase in people coming to jail with mental health issues” because of the closure.

Louisiana’s latest round of austerity measures come on the heels of significant national movement on the health care issue, with the Supreme Court’s deciding to uphold the Affordable Care Act in late June. The law allows states to expand Medicaid coverage to approximately 17 million of the country’s estimated 30 million uninsured residents. In spite of the budgetary crunch facing the state and a decrease in its federal Medicaid funds, Governor Jindal has stated that Louisiana will not participate in the expanded Medicaid system.

The Governor’s Office did not re­spond to questions The Louisiana Weekly submitted by email in time for publication.

Jindal has a long history of cutting the state’s healthcare infrastructure costs. He was appointed to run the Department of Health and Hospitals in 1996 when it accounted for 40 percent of the state’s budget and ran a deficit. Under his watch, the shortfall converted to a surplus, but critics charge that the surplus appeared when small clinics were shut down.

Potash criticized the manner in which state officials decided to close SELH. “Logic would say: ‘why would they close South­east?’ This was a secretive decision, and when you make political decisions in secret, they’re made without the benefit of sound information and input. So by it’s very nature it’s pretty much guaranteed to be wrong.”

This article originally published in the July 23, 2012 print edition of The Louisiana Weekly newspaper.